^(99)Tc^m-MAA肺灌注显像评价肺动脉血栓内膜剥脱术疗效  

Evaluation of thromboendarterectomy by pulmonary perfusion imaging in patients with chronic pulmonary thrombo-embolic hypertension

作　　者：方纬[1] 史蓉芳[1] 刘秀杰[1] 吴清玉[2] 潘世伟[2] 宋云虎[2] 何作祥[1] 

机构地区：[1]中国医学科学院,中国协和医科大学阜外心血管病医院核医学科,北京100037 [2]中国医学科学院,中国协和医科大学阜外心血管病医院心外科,北京100037

出　　处：《中华核医学杂志》2006年第6期334-337,共4页Chinese Journal of Nuclear Medicine

基　　金：北京市科技计划项目资助(Y0204004040731)

摘　　要：目的应用^(99)Tc^m-大颗粒聚合白蛋白(MAA)肺灌注显像评价肺动脉血栓内膜剥脱术对慢性栓塞性肺动脉高压(CPTH)疗效,并与电子束CT(EBCT)进行对比。方法9例CPTH患者,于手术前、术后早期(6～30 d)和术后远期(6～12个月)分别进行肺灌注显像,对图像进行逐个肺段的定性和半定量分析,比较手术前后肺血流灌注的变化,并与EBCT进行逐个肺段的对比分析。结果术前99个肺段显示灌注异常,术后早期42个(42．4%)恢复正常,28个(28．3%)部分改善;术后远期完全恢复的肺段为69．7%(69/99个)。术前全肺灌注缺损百分数(PPDs%)平均为(60．8±6．5)%,术后早期下降为(46．1±11．8)%(P＜0．01);术后远期进一步下降为(13．3±13．5)%(P＜0．01)。按肺段统计,手术前后肺灌注显像与EBCT结果均符合为60．3%。结论^(99)Tc^m-MAA肺灌注显像是评价肺动脉血栓内膜剥脱术后疗效的有效方法。Objective Thromboendarterectomy was accepted as an effective treatment for patients with chronic pulmonary thrombo-embolic hypertension. The aim of the study was to evaluate the efficiency of pulmonary perfusion imaging in assessing the changes of regional pulmonary perfusion after the therapy in comparison with that of electron beam computed tomography （EBCT）. Methods Nine patients with chronic pulmonary thrombo-embolic hypertension underwent pulmonary perfusion imaging before and after thromboendarterectomy. Analysis of pulmonary perfusion images and the agreement analysis between pulmonary perfusion imaging and EBCT were performed on segment-by-segment basis. Percentage of perfusion defect scores （PPDs%） was calculated. Results Regional perfusion defects were found in 99 segments before thromboendarterectomy. Pulmonary perfusion became normal in 42 segments（42.4% ）, and improved in 28 （28.3%） 6 - 30 d after thromboendarterectomy. 69.7% of pulmonary segments became normal 6 - 12 months after thromboendarterectomy. The mean PPDs% reduced from （ 60.8 ± 6.5 ） % to （46.1±11.8） % （ P 〈 0. 01 ） at 6 - 30 d and to （ 13.3±13.5 ） % （ P 〈 0.01 ） at 6 - 12 months after thromboendarterectomy. The agreement between pulmonary perfusion imaging and EBCT was 60. 3% in evaluating the effect of y on segment-by-segment basis. Conclusion This study suggests that pulmonary perfusion imaging is a reliable method for evaluation of the changes in pulmonary perfusion after thromboendarterectomy.

关 键 词：肺动脉 血栓形成 手术后期间 放射性核素显像 MAA 体层摄影术 X线计算机 

分 类 号：R817.4[医药卫生—影像医学与核医学]